Adolescent Changes in Cellular Proliferation in the Dentate Gyrus of Male and Female C57BL/6N Mice Are Resilient to Chronic Oral Corticosterone Treatments.

Adolescent development is marked by significant changes in neurobiological structure and function. One such change is the substantial adolescent-related decline in cellular proliferation and neurogenesis in the dentate gyrus of the hippocampal formation. Though the behavioral implications of these developmental shifts in cell proliferation are unclear, these changes might contribute to the altered cognitive and emotional functions associated with puberty and adolescence. The significant decrease in cellular proliferation throughout adolescence might make the hippocampus more vulnerable to perturbations during this developmental stage, particularly to factors known to disrupt neurogenesis, such as chronic exposure to stress-related hormones. To examine this possibility, we first measured cellular proliferation in the dentate gyrus of male and female C57BL/6N mice before and after adolescence and then assessed both cellular proliferation and the number of immature neurons in mice treated with oral corticosterone for 4 weeks during either adolescence or adulthood. We found significant age-related decreases in hippocampal cellular proliferation in both males and females. Though the greatest decrease in proliferation was during adolescence, we also observed that proliferation continued to decline through young adulthood. Despite the significant effect of chronic oral corticosterone on body weight gain in both the adolescent- and adult-treated males and females and the subtle, but significant suppressive effect of corticosterone on the number of immature neurons in the adolescent-treated males, cell proliferation in the hippocampus was unaffected by these treatments. These data show that the substantial adolescent-related change in cellular proliferation in the dentate gyrus is largely unaffected by chronic oral corticosterone exposure in males and females. Thus, despite being vulnerable to the metabolic effects of these chronic corticosterone treatments, these results indicate that the developmental changes in cellular proliferation in the dentate gyrus are relatively resilient to these treatments in mice.

A migraine management training program for primary care providers: An overview of a survey and pilot study findings, lessons learned, and considerations for further research.

BACKGROUND: There are five to nine million primary care office visits a year for migraine in the United States. However, migraine care is often suboptimal in the primary care setting. A prior study indicated that primary care physicians (PCPs) wanted direct contact with headache specialists to improve the migraine care they provide. OBJECTIVE: We sought to further examine PCPs' knowledge of migraine management and assess the feasibility of a multimodal migraine education program for PCPs. METHODS: We conducted a survey assessing PCPs' knowledge about migraine. We then held three live educational sessions and developed an email consultative service for PCPs to submit questions they had about migraine. We report both quantitative and qualitative findings. RESULTS: Twenty-one PCPs completed the survey. They were generally familiar with the epidemiology of migraine (mean prevalence of migraine reported was 12.6% ± 10.1), the psychiatric comorbidities (mean prevalence of comorbid depression was 24.5% ± 16.7, mean prevalence of comorbid anxiety was 24.6% ± 18.3), and evidence-based behavioral treatments. Fifty-six percent cited cognitive behavioral therapy, 78% cited biofeedback, and 61% cited relaxation therapy as evidence based treatments. Though most were aware of the prevalence of psychiatric comorbidities, they did not routinely assess for them (43% did not routinely assess for anxiety, 29% did not routinely assess for depression). PCPs reported frequently referring patients for non-level A evidence based treatments: special diets (60%), acupuncture (50%), physical therapy (30%), and psychoanalysis (20%). Relaxation therapy was a therapy recommended by 40% of the PCPs. Only 10% reported referring for cognitive behavioral therapy or biofeedback. Nineteen percent made minimal or no use of migraine preventive medications. Seventy-two percent were unaware of or only slightly aware of the American Academy of Neurology guidelines for migraine. There was variable attendance at the educational sessions (N=22 at 1st session, 6 at 2nd session, 15 at 3rd session). Very few PCPs used the email consultative service (N=4). CONCLUSIONS: Though PCPs are familiar with many aspects of migraine care, there is a need and opportunity for improvement. The three live sessions were poorly attended and the email consultative service was rarely used. We provide an in depth discussion of targeted areas for educational intervention, of the challenges in developing a migraine educational program for PCPs, and areas for future study.